Gout and Kidney Disease
There is a strong connection between gout and kidney disease. People with gout are more likely to develop kidney problems, and those with chronic kidney disease (CKD) often have high uric acid levels that trigger gout. As kidney function declines, the body struggles to filter toxins and uric acid, leading to crystal buildup and inflammation.
At Bolad Arthritis & Rheumatology Clinic in Tampa and Orlando, our gout specialists provide targeted gout treatment to help protect kidney health. With proper medication and care, uric acid buildup can be controlled and kidney function may even improve over time.
Symptoms of Gout
Tophi
A common sign of uncontrolled gout is the formation of firm bumps called tophi, which develop when uric acid crystals accumulate under the skin or around joints. The immune system tries to dissolve these crystals, but when it can’t keep up, the crystals clump together and form tophi.
Tophi can appear near joints or along the skin and may cause bone erosion or permanent joint damage over time. In severe cases, they can even break through the skin, releasing a chalky white substance.
At Bolad Arthritis & Rheumatology Clinic in Tampa and Orlando, our gout doctors specialize in advanced gout treatment to lower uric acid, shrink tophi, and prevent further joint destruction.
Gout flares often occur suddenly and can last from a few days to several weeks. These attacks usually affect one joint—most commonly the big toe, ankle, or knee—but can sometimes move between joints. Triggers may include certain foods, injury, or nighttime onset.
Typical symptoms include:
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Intense joint pain and stiffness
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Swelling, redness, and warmth
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Extreme tenderness or discomfort
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Development of tophi (crystal deposits) over time
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Joint erosion or long-term damage
At Bolad Arthritis & Rheumatology Clinic in Tampa and Orlando,
our specialists provide expert gout treatment to relieve
flare symptoms and prevent future attacks
What Causes Gout Flares?
Gout flare causes vary between individuals, but common causes may include:
• Dehydration
• Stress
• Change in routine (travel or major life event)
• High purine diet
• Certain medications
• Injury
Tophi
In uncontrolled gout, hard lumps called tophi can form. These happen when uric acid crystals build up and the immune system can’t clear them. The body then tries to isolate the crystals, creating these lumps.
Tophi may appear under the skin or near joints. Over time, repeated gout flares can damage the bone, causing joint erosion. This damage is often permanent.
Sometimes, tophi may break through the skin and release a chalky white substance.
Interestingly, when uric acid remains high, flare-ups may decrease but tophi increase—a sign that gout is worsening, not improving.
At Bolad Arthritis & Rheumatology Clinic in Tampa and Orlando, our specialists provide advanced gout treatment to prevent tophi buildup and protect joint health.
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What is Gout
Gout is a chronic form of arthritis that can cause pain, swelling, and stiffness in the joints—most often in the big toe, ankle, knee, or wrist. It’s a systemic condition that may also affect the bones, heart, and kidneys if left untreated. At Bolad Arthritis & Rheumatology Clinic in Tampa and Orlando, our expert gout doctors provide personalized gout treatment to manage inflammation, prevent flare-ups, and protect joint health. As a trusted gout clinic and gout center, we help patients understand their condition and create long-term solutions for lasting relief.
Purines and Gout
Purines are natural compounds found in certain foods and produced by the body. When broken down, they create uric acid, which is normally filtered out through urine. When uric acid levels rise above 7 mg/dL, the body can’t remove it effectively, leading to a buildup in the blood—a condition called hyperuricemia. At Bolad Arthritis & Rheumatology Clinic in Tampa and Orlando, our specialists help identify and manage high uric acid levels to prevent gout and joint inflammation.
Uric Acid Buildup
When uric acid levels become too high, tiny crystals can form in the joints—especially in the big toe, ankle, or knee—where blood flow is slower and temperatures are lower. These uric acid crystals trigger intense inflammation, causing red, hot, and swollen joints typical of a gout attack. At Bolad Arthritis & Rheumatology Clinic in Tampa and Orlando, our rheumatology experts specialize in diagnosing and treating gout to reduce pain and prevent future flares.
What Causes Gout?
Many people believe gout is caused mainly by diet. While certain foods and alcohol can make gout worse, diet is not the main cause. Even people who eat very healthy and avoid high-purine foods can still get gout.
There is no single cause of gout. It can affect anyone, and it progresses differently from person to person. This is why treating gout has traditionally been challenging.
Genetics
Gout can run in families and becomes more common with age as kidney function declines. Postmenopausal women and people with psoriasis or undergoing chemotherapy are also at higher risk due to changes in uric acid levels.
UltraMedications
Certain medications, like diuretics used for high blood pressure, can raise the risk of gout. These “water pills” increase urination, which can lead to dehydration and higher uric acid levels—causing crystals to form and trigger gout attacks.
Dialysis
Dialysis also shares a link to the development of gout. When the kidneys do not work appropriately, there is little uric acid that can leave the body and therefore, it can collect in the joints and tissues more readily.
Immunosuppressants
Immunosuppressants like cyclosporine, often used after organ transplants, can raise the risk of gout by reducing the kidneys’ ability to remove uric acid from the body.
Gout Diagnosis
If you are experiencing one or more of the common symptoms of gout, your rheumatologist may perform several tests to rule out other potential causes for your symptoms. Patients require a diagnosis before they may begin gout treatment.
Uric Acid Blood Test
Uric acid levels are checked with a simple blood test, and fasting isn’t required. Normal levels range from 3.5 to 7.0 mg/dL, but for people with gout, the target is below 6 mg/dL according to the American College of Rheumatology guidelines.
Synovial Fluid Test
A synovial fluid test involves removing fluid from a swollen joint and looking for uric acid crystals under a polarized microscope. This is performed by a healthcare professional. The fluid is then sent to the lab to be analyzed.
Ultrasound
Ultrasounds are a non-invasive imaging test that uses sound waves to examine tissues, organs, and other body structures. Your doctor may order an ultrasound test to examine a swollen joint. Ultrasounds are occasionally used to detect tophi and determine if there are characteristic features of gout within an area of swelling.
X-Rays
X-rays can be helpful in identifying common signs of gout within a joint. X-rays will only show bone and do not show soft tissue swelling or gout if it affects the tendons. For patients who complain of joint pain, an X-ray can identify if there are features of bone erosions or damage to the bone structure caused by gout.
Dual Energy CT Scan (DECT)
Dual Energy CT scan is an imaging technique that can detect uric acid deposition anywhere in the body with the use of CT scan and specific technology. This imaging can only be performed with specialized CT scanners at select imagine centers and is an extremely helpful tool to diagnose gout and tophi, as well as monitor progress on gout treatment.
Gout Treatment
Tophi
Severe gout pain is very common for those who have the condition, and gout flares can stop even the most physical person in their tracks. There are ways to help manage symptoms of gout. Like all medical conditions, it takes a little bit of work and adjustments in medication.
At the Bolad Clinic Gout Center, we strive to help our patients manage flares and recover as quickly as possible. Our goal is to treat current flares and manage the condition to prevent future flareups. In doing so we will be preventing further joint damage or even internal organ damage in those who have suffered from gout for a longer period of time.
Often, we can help manage flares with rapid appointment scheduling at one of our clinics. We want you to leave each appointment feeling like you understand your gout treatment plan and customized approach to achieve remission.
A common feature of uncontrolled gout is the formation of large bumps called tophi. Tophi form from the collection of gout crystals that the body is trying to wall off or ignore. White blood cells of the immune system try to dissolve uric acid crystals. But when the immune system cannot keep up with all the crystals, the white blood cells then try to “hide” the uric acid in clumps that develop into tophi.
Sometimes, tophi can be along areas of the skin or right next to a joint. Erosions in the joints or bones are collections of uric acid that have caused damage to the bone structure. This happens when there are repetitive gout flares in the joint and the immune system starts causing damage to the bone by trying to “eat away” at the uric acid.
Over time, joint damage that occurs from gout is difficult to treat and considered irreversible. Tophi can sometimes burst open from the skin and a chalking white-yellow substance might be visible.
Ironically, when levels of uric acid remain high enough, some people can see a decrease in gout flares and an increase in tophi. This actually means that their gout is progressing and becoming more severe.
Gout Diet
While changing your diet won’t cure gout, it can reduce the frequency of flare-ups and slow joint or kidney damage. A gout diet focuses on lowering purine intake, which helps reduce uric acid levels in the blood.
If you have uncontrolled gout, avoid red and organ meats, shellfish, beer and liquor, and sugary foods or drinks. Once your gout is under control, you may enjoy some of these in moderation. Increasing vitamin C, coffee, and tart cherry juice may also help lessen inflammation naturally.
At Bolad Arthritis & Rheumatology Clinic in Tampa and Orlando, our gout specialists combine dietary guidance with personalized gout treatment plans to help patients manage symptoms and prevent future flares.
Lifestyle Modifications
Lifestyle changes play an important role in managing gout symptoms and preventing flares. Being overweight increases the risk of gout, so gradual weight loss can help lower uric acid levels and reduce flare frequency—even without major diet changes.
Regular moderate exercise, such as walking or swimming, helps improve blood flow and reduce inflammation. However, high-impact or intense workouts that stress the joints or cause dehydration can trigger flares
Medication for Gout
Gout treatment includes medications that relieve flare-ups and those that lower uric acid levels to prevent future attacks.
For symptom relief:
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NSAIDs (Ibuprofen, Celebrex, Indomethacin)
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Corticosteroids (Prednisone, Medrol)
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Colchicine (Colcrys, Mitigare)
To lower uric acid:
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Allopurinol
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Febuxostat (Uloric)
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Pegloticase (KRYSTEXXA®)
KRYSTEXXA® IV therapy, given every two weeks, is one of the most effective treatments for severe or chronic gout.
At Bolad Arthritis & Rheumatology Clinic in Tampa and Orlando, our gout specialists tailor medication plans to each patient’s needs—helping reduce flares, lower uric acid, and prevent long-term joint or kidney damage.
📍 Schedule a visit at our Gout Clinic in Tampa or Orlando to begin your personalized gout treatment plan
Our Team
The Team
Dr. Waleed Bolad
(Major Blvd. Clinic, Orlando, Vineland Rd. Clinic, Orlando & Tampa Clinic)
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Dr. Sukhraj Singh
(Vineland Rd. Clinic, Orlando)
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Dr Omer Idrees
(Major-Orlando)
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Alissa Ledgerwood
ARNP
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Alona Dniprovska
APRN - C, PhD
Our Clinic Hours
Flexible scheduling that fits your routine, because healthcare/medical care should work on your time
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Friday
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Friday
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Orlando phone:
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Friday
8:30 AM -12:00 PM
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5750 Major Blvd, Ste 150
Orlando, FL 32819
(407) 409-8118
(407) 930-4522
Mon-Thurs 7:30 AM - 5:00 PM
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Orlando phone:
6001 Vineland Rd, Ste 106
Orlando, FL 32819
(407) 409-8118
(407) 930-4522
Mon-Thurs 8:30 AM - 12:00 PM
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Tampa office :
4728 N Habana Ave, Ste 303
Tampa, FL 33614
(813) 343-0400
(813) 666-2806
Mon-Fri 8:00 AM - 5:00 PM
Tampa phone:
4728 N Habana Ave, Ste 303
Tampa, FL 33614
(813) 343-0400
(813) 666-2806
Mon-Fri 8:00 AM - 12:00 PM
1:00 PM - 5:00 PM